Under the Millennium Development Goal (MDG) 4, target is to reduce Child Mortality by two-third between 1990 and 2015. In case of India, it translates into a goal of reducing Infant mortality rate from 88 per thousand live births in 1990 to 29 in 2015. As per Sample Registration System (SRS), 2013 reports published by Registrar General of India the Infant Mortality Rate (IMR) of India is 40 per 1000 live births. It may reach 35 by 2015 if the current trend of annual decline of 5.6 per cent continues.
Under National Health Mission, the following interventions are being implemented to reduce infant mortality rate and maternal mortality ratio in the Country:
1. Promotion of institutional deliveries through Janani Suraksha Yojana.
2. Operationalization of sub-centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.
3. Name Based Web enabled Tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.
4. Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.
5. Antenatal, intranatal and postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia.
6. Engagement of more than 8.9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.
7. Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.
8. Adolescent Reproductive Sexual Health Programme (ARSH) – Especially for adolescents to have better access to family planning, prevention of sexually transmitted Infections, Provision of counselling and peer education.
9. Health and nutrition education to promote dietary diversification, inclusion of iron and folate rich food as well as food items that promote iron absorption.
10. Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.
11. Universal Immunization Programme (UIP): Vaccination protects children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Infants are thus immunized against seven vaccine preventable diseases every year. The Government of India supports the vaccine programme by supply of vaccines and syringes, cold chain equipment and provision of operational costs.
12. Strengthening Facility based newborn care: Newborn care corners (NBCC) are being set up at all health facilities where deliveries take place; Special New Born Care Units (SNCUs) and New Born Stabilization Units (NBSUs)
are also being set up at appropriate facilities for the care of sick newborn including preterm babies.
13. Home Based Newborn Care (HBNC): Home based newborn care through ASHA has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies
14. Capacity building of health care providers: Various trainings are being conducted under National Health Mission (NHM) to build and upgrade the skills of health care providers in basic and comprehensive obstetric care of mother during pregnancy, delivery and essential newborn care.
15. Management of Malnutrition: Nutritional Rehabilitation Centres (NRCs) have been established for management of severe acute malnutrition in children.
16. India Newborn Action Plan (INAP) has been launched to reduce neonatal mortality and stillbirths.
17. Newer interventions to reduce newborn mortality- Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, kangaroo mother care and injection gentamicin for possible serious bacillary infection.
18. Intensified Diarrhoea Control Fortnight was observed in August 2014 focusing on ORS and Zinc distribution for management of diarrhoea and feeding practices.
19. Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest infant mortality (UP, MP, Bihar and Rajasthan).
The prominent causes of death among infants as per RGI-SRS (2001-03) are perinatal conditions (46%), respiratory infections (22%), diarrhoeal disease (10%), other infectious and parasitic diseases (8%), and congenital anomalies (3.1%). Besides this, Illiteracy, low socio-economic status, early age of marriage, high parity, women’s empowerment, poor sanitation, hygiene and nutrition, poor access to health facilities are also contributing factors of Infant and Child mortality
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